Many insurers are falling short on mental health parity, according to a new federal report.
Mental health parity laws require that insurers cannot impose financial requirements or treatment limitations on mental health care that exceed those on physical care services. The report, issued by the departments of Labor, Health and Human Services (HHS) and Treasury to Congress, found many insurers are failing in this regard.
For example, the analysis found one payer covered nutrition services for people who have diabetes but not mental health conditions such as anorexia, bulimia or binge eating disorder.
“Access to mental and behavioral health support is critical as the COVID-19 pandemic continues to impact so many lives across the country,” said HHS Secretary Xavier Becerra in a statement. “Unfortunately, as today’s report shows, health plans and insurance companies are falling short of providing access to the treatment many working families need."
"We are committed to working with our federal partners to change this and hold health plans and insurance companies accountable for delivering more comprehensive care," Becerra said.
The report notes that the Biden administration has put a focus on enforcement for mental health parity.
The Employee Benefits Security Administration has issued 156 letters across 86 investigations, according to the report. The Centers for Medicare & Medicaid Services has also issued 15 letters between May and November 2021 in states where it has authority over mental health parity, namely Texas, Missouri and Wyoming, as well as to nongovernmental plan sponsors.
The report also highlights one of the feds' largest enforcement activities to date on mental health parity: a $15.6 million settlement with UnitedHealthcare. The country's largest commercial insurer would routinely lower reimbursement rates for out-of-network behavioral health services and would flag members with behavioral health needs for utilization reviews.
The August 2021 settlement includes $13.6 million in wrongfully denied claims and $2 million in lawyer fees and penalties.
“In the past year, the Employee Benefits Security Administration has placed great emphasis on ensuring parity for mental health and substance use disorder benefits,” said acting Assistant Secretary for Employee Benefits Security Ali Khawar in a statement. “As we continue to strengthen and build on these efforts through regulation, enforcement and compliance assistance, EBSA is determined to deliver on the law’s promise.”